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All Journal Health Science Journal of Indonesia International Journal of Social Service and Research
Mardiati Nadjib
Department of Health Administration and Policy, Faculty of Public Health, Universitas Indonesia
Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Environmental Science Health Professions Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Nursing Public Health Social Sciences

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Policy options to integrate HIV services into Social Health Insurance (JKN) in Indonesia Mardiati Nadjib; Purwa Kurnia Sucahya; Mondastri Korib; Ratih Oktarina; Pujiyanto Pujiyanto; Amila Megraini; Hendri Hartati; Pandu Harimurti
Health Science Journal of Indonesia Vol 10 No 1 (2019)
Publisher : Sekretariat Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/hsji.v10i1.1604

Abstract

Latar belakang: Setelah sekian tahun bergantung pada sumber pendaaan luar negeri, pembiayaan Program HIV AIDS di Indonesia diharapkan menggunakan sumber pendanaan dalam negeri. Skema Jaminan Kesehatan Semesta atau Jaminan Kesehatan Nasional (JKN) yang dimulai tahun 2014 menanggung pengobatan termasuk infeksi oportunistik. Pertanyaan penelitian apakah paket manfaatnya dapat mencakup intervensi kesehatan masyarakat seperti HIV tanpa menghambat penyediaan pelayanan? Implementasi untuk Program HIV yang selama ini disubsidi Pemerintah memerlukan kehati-hatian. Studi ini bertujuan untuk menganalisis skenario terkait biaya dan utilisasi pada pelayanan HIV guna mendukung kebijakan yang potensial untuk mengintegrasikan intervensi HIV ke dalam paket manfaat JKN. Metode: Penelitian ini menganalisis paket manfaat dan mekanisme pembiayaan terkait pelayanan HIV, keanggotaan JKN, target populasi kunci, serta estimasi premi untuk pelayanan HIV hingga tahun 2019. Studi observasional ini menghasilkan data biaya dan utilisasi dari tingkat nasional dan daerah sebagai data dasar. Peneliti membangun model dan menganalisis skenario proyeksi biaya dan utilisasi dari beragam program aktivitas HIV serta konsekuensinya. Hasil: Skenario dikembangkan berdasarkan kelengkapan paket manfaat dan komponen mana yang bisa dijamin dalam JKN.Pelayanan yang terkait HIV saat ini sebagian besar dijamin oleh pemerintah mulai dari Konseling dan Tes HIV Sukarela (KTS) hingga pengobatan Infeksi Oportunistik. Pengobatan dan perawatan kemungkinan dapat dijamin oleh JKN, dengan bantuan pemerintah untuk pencegahan dan pelayanan ART. Kesimpulan: Skenario dengan paket manfaat dasar akan membutuhkan biaya medis yang rasional per pasien per bulan, tergantung pada kelengkapan paket manfaat. Sebuah peta jalan yang jelas perlu disusun untuk memastikan seluruh pelayanan terjangkau dan berkualitas baik. Kata kunci: Jaminan kesehatan semesta, pelayanan HIV, dan Opsi Kebijakan Abstract Background: HIV and AIDS program in Indonesia is planned to be financed by domestic sources after depending on external sources for many years. Indonesia has started its Social Health Insurance scheme so called Jaminan Kesehatan Nasional (JKN) program in 2014, that covers HIV treatment including opportunistic infection. Research question is whether JKN could expand its benefit package to public health interventions without hampering service provision. Converting HIV program that has been subsidizied by the Government needs careful considerations. The study aimed to assess scenarios on cost and utilization to support decision on integration of HIV interventions into the JKN benefit package. Methods: The study assessed the current coverage and funding mechanisms for HIV-related services, JKN membership, key target populations, and estimated premium for HIV services up to 2019. We captured cost and utilization from national and subnational levels as the baseline through an observational study. Researchers developed model and scenarios on the projection of cost and utilization of various HIV program activities and its consequences. Results: We developed scnearios based on benefit covered by JKN. current services mostly covered by government. The Care and treatment could be possibly covered by the JKN, with support from government for prevention and ART. Conclusion: The scenarios show that provision of HIV services within the basic benefits package of JKN would require a reasonable cost per member per month, depending on the comprehensiveness of the benefit. A clear roadmap should be developed to ensure all services provided are affordable and in good quality. Keywords: Universal Health Coverage, HIV AIDS, Policy Option
Implementation of Cervical Cancer Early Detection Program with IV A Test Method in Cilegon City in 2022 Melisa Charoline Rembet; Mardiati Nadjib
International Journal of Social Service and Research Vol. 3 No. 7 (2023): International Journal of Social Service and Research (IJSSR)
Publisher : Ridwan Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/ijssr.v3i7.442

Abstract

Background: With the high number of cancer cases and deaths and the continued increase in cancer financing, which has caused a number of countries, including Indonesia, to continue to struggle to reduce the impact of cancer, the things that must be done are detection, screening, and treatment, as well as palliative care, which are key components of the response to cancer. Early detection is a major step toward increasing the chances of cancer survivors becoming survivors. The achievement of early detection of cervical cancer in Indonesia in 2019–2021 is still low, at 6.83%, or as many as 2,827,177 women aged 30–50 years have undergone early detection of cervical cancer with the Visual Acetate Inspection (IVA) method. Banten Province only reached 5.61%, which means that it is below the average achievement of Indonesia, and Cilegon City is also still low in the achievement of early detection of cervical cancer in 2021, which is 1.2%. The purpose of this study is to determine the picture of the implementation of the cervical cancer early detection program with the IVA method in Cilegon City and identify obstacles that arise in its implementation. Method: This research is qualitative research with a descriptive approach. Data collection techniques include in-depth interviews, group discussion forums, and document review. Results: The results showed that the availability of SOPs, facilities, and infrastructure that support the implementation is not yet balanced between human resources and the target of the cervical cancer early detection program. There are constraints in the process of implementation, recording, and reporting, as well as low differences in perception in calculating the target achievement of the cervical cancer early detection program. Conclusion: The implementation of the early detection program in all Public Health Center in Cilegon City in 2022 is in accordance with the policy, even though there are still obstacles in its implementation, both passively and actively, so that achievement is still very low.
Co-Authors Amila Megraini Hendri Hartati Melisa Charoline Rembet Mondastri Korib Pandu Harimurti Pujiyanto Pujiyanto Purwa Kurnia Sucahya Ratih Oktarina